No Longer a Matter of If, but When

I met with a surgeon Feb. 23. He took more x-rays and told me that my left knee is plumb wore out (not in exactly those words). He said surgery should have been done several years ago. Not only is the cartilage gone but there are bone spurs all over the joint. When I asked if there were specific exercises I could do before surgery he said not really, ride a stationary bike if you can, do some leg lifts, but until those bone spurs are gone there is not much to be done.

He asked when I wanted it done and I said as soon as possible. But when I got home and started thinking about it I realized that I had not taken all things Medicare into account. I learned that hospital coverage ("part B") does not cover the doctor's costs - or, in fact, the anesthesiologist's. I would have to pay 20% of those costs in addition to a "hospital deductible". There is a difference between in-patient and out-patient status as well, so the transitional care might also require a 20% co-payment. I got to thinking that maybe I need a Medicare supplement after all.

I hunted around and found a supplement that looks right for me and signed up. As I understood what I read, this first surgery would not be covered if I have it done right away. I will probably have to wait a few months. I am going to call the agency tomorrow to find out if I read that right.

I am definitely having this surgery. My knees are too far gone for any other program to help them now. The surgery will be "minimally invasive" so I should be on my feet the day of the surgery, which is a relief.

Obviously this changes this blog. I really wanted to manage this arthritis without surgery but it has become so disabling that I am accepting the need. I am continuing to go to the gym because I am sure that the more flexible and strong I am the better.

Almost No Pain Yesterday

I realized yesterday, at the gym, that I was peddling along with no pain. I then paid attention to the rest of the workout and caught myself doing things with more ease than I have most of the time. Frankly, I do not think I have finally broken through the pain barrier. More likely the reason for my feeling less pain is one or more of the following:

* I have been taking tylenol arthritis twice a day, in the morning and at night, for the past several days.
* I did not go to the gym for two days prior to yesterday, for different reasons, so I was extra-rested.
* I tend to have ups and downs with the pain for no reason I have ever figured out.

I am going to keep taking the tylenol for now.

Right leg

For the past several days I have had more pain in my right leg. Not only my hip, but my thigh and calf. At night my calf is often in such discomfort I can't get to sleep. I have begun to take Tylenol Arthritis fairly regularly to help with this discomfort. It seems to help me get enough relief to get to sleep.

Tramadol

A few days after starting on Tramadol I have stopped taking it. The nausea was just too much. Yesterday I took about 2/3 of a tablet in the morning, no more later, and this morning I still felt sick.

I understand that sometimes the nausea will go away over time but I don't feel willing to wait. Perhaps when the subject of pain relief comes up again I can discuss anti-nausea meds as well. Much as I hate to add more drugs to the soup, I do feel I need to find something that can take pain away and does not cause me some kind of distress. When I have surgery I will need something during the recovery and rehabilitation period, to allow me to work on the joints without severe pain.

Just to play catch-up: I don't use NSAIDs because they cause stomach issues, including two instances of ulcers. I use acetaminophen occasionally but it isn't particularly powerful, and it too has side effects that worry me if I take it regularly.

Changes ahead

Two days ago I had an appointment with my regular doctor, to discuss options for my arthritis. I told him that I am living about 1/3 of the life I would be without arthritis, that I am in pain when I walk and when I stand, that this pain prevents me from doing many things alone and with my children. I told him about my efforts at the gym and beyond, and said I don't normally take pain relievers because of the effects on my stomach.

He said the only solution that makes sense for me is knee surgery. It's a "no-brainer", he said, and then sent me to get some x-rays of my left knee. When he came back in the room he said it hurt just to look at the x-rays, and he prescribed some Tramadol, a narcotic, for the short-term, and made a referral to an orthopedic surgeon. The appointment will be made when I get approval from Medicare.

In the meantime I went to get the Tramadol. I started taking it at about noon yesterday. It makes me fuzzy, as narcotics usually do. I do feel some relief from the pain, though, so I am going to keep taking it, to see if the fuzzy effects go away and the pain relief remains.  Right now I just feel like lying down.

Treading Water

It seems that I am treading water now. I am not progressing but neither am I regressing, best as I can tell. When I was sick for a couple of weeks, away from the gym, I was able to tell the difference in my aerobic capacity and endurance when I returned to Aqua classes. So I know I am doing something. But it isn't much. At times I feel discouraged.

Today I went to the gym early because I have sewing class soon, and I was simply in pain the whole way through. I wanted to quit. I didn't. How long can I keep on feeling this way?

The Left Leg, the Right Hip

Sometimes, out of the blue, I feel a sharp twinge in the area just below my left knee. It is pain combined with a stiffness, that odd kind of arthritic stiffness that I associate with an arthritic "flareup".  It usually eases off a bit but not always.  It has happened a couple of times lately when I was in the middle of doing leg presses, and continued through the rest of my gym routines.

Sometimes I wake with right hip pain. Sometimes it eases off soon, but other times it just won't. Today, for example, it caused me difficulty getting around the house. I hoped that the Aqua class might actually help it but it didn't. In fact, the frantic water-walking we did today had me almost biting my tongue as I kept hoping it would ease up. It never did and it still hasn't.

These are the two pain issues that most affect me right now. Even when I start off feeling good, going to the market for example, in no pain, one or another of the two will often slip in and make my feel-good time not so feel-good.